Last week, two Georgia U.S. Attorney’s Offices announced multi-million dollar False Claims Act (FCA) settlements with major health systems.  First, on June 24, the U.S. Attorney’s Office for the Southern District of Georgia announced that Augusta University Medical Center (AUMC) had agreed to pay over $2.6 million to settle an FCA investigation involving allegations of false billing.  Specifically, the government alleged that AUMC knowingly submitted false claims to federal healthcare programs for a procedure that was not covered by Medicare or Medicaid.  According to the government’s press release, from the early stages of the investigation, AUMC “actively cooperate and fully committed to both monetary and non-monetary corrective actions for the alleged misconduct.”

The next day, the U.S. Attorney’s Office for the Northern District of Georgia announced that Piedmont Healthcare had agreed to pay $16 million to settle two separate FCA allegations brought in a qui tam (whistleblower) lawsuit.  The first allegation was that Piedmont “allegedly overturned the judgment of its treating physicians on numerous occasions and billed Medicare and Medicaid at the more expensive inpatient level of care even though the treating physicians recommended performing the procedures at the less expensive outpatient or observation level of care.”  The second FCA allegation against Piedmont related to the acquisition of a physician practice group in 2007.  According to the allegations, Piedmont paid a commercially unreasonable and above fair market value for a catheterization lab partly owned by the practice group.  The DOJ stated that the whistleblower would receive just under $3 million of the settlement.

The attorneys at Chilivis Grubman represent clients of all types and sizes in connection with False Claims Act investigations and litigation.  If you need assistance with such a matter, please contact us today.